RESULTS OF A MULTICENTER TRIAL USING A MECHANICAL LITHOTRIPTER FOR THE TREATMENT OF LARGE BILE-DUCT STONES

A prospective, uncontrolled trial of the use of a prototype mechanical lithotripter was performed in 116 patients at nine centers. Standard endoscopic approaches had failed to remove all stones, primarily becau se of large size (80% of patients). For 92% of patients, common bile d uct stones were successfully captured and fragmented following the use of this lithotripter. The frequency of pancreatitis and hemorrhage wa s no greater than with standard endoscopic retrograde sphincterotomy, and complications unique to lithotripter use were not noted. For endos copists skilled in therapeutic duodenoscopy, this modality should be c onsidered in management of common bile duct stones refractory to stand ard techniques.